Please Discuss - What are your thought re: Elective Induction

At our Childbirth class last night, the nurse (teacher) advised us that our Dr. does MANY elective inductions as a matter of convenience -

IF your cervix is 'ripe' and ready to go and you are at least 39 weeks he will induce you over the weekend to do his best to keep the office and patient appointments etc running smoothly for the week ..........She said b/c he ONLY induces you according to those rules, his C section ratio is EXTREMELY low -

Part of me has no problem with this
1. B/c I'm all for advances in modern medicine and I trust my Dr. not to do something stupid
and
2. b/c I've obvioiusly benefited from his practices and often wondered why I never had a cancelled appointment and he rarely had an 'emergency'

The other part of me is like - Isn't this supposed to just happen when it's supposed to happen??


Now obviously, I don't have to agree to his induction schedule if I'm not comfortable with it - and he's not at all the type to try to force you to do anything you're uncomfortable with so I'm not worried about telling him 'no' if that is his suggestion ...........
i'm just looking for opinions and pros/cons ???
What are your thoughts ??

Re: Please Discuss - What are your thought re: Elective Induction

Inductions are very very risky, and a failed induction will result in a C-Section. I was induced and it was AWFUL!!! I was in labor from 6 am Saturday Morning and my son was born at 9 pm Monday night. I wouldn't choose induction again, and I would highly resent my doctor (not to mention not trust him) if he induced me to keep his office running smoothly over the weekend. Thats terrible

With his baby I am going to sit at home until it pops out.

Re: Please Discuss - What are your thought re: Elective Induction

Every induction is differnt. I was induced at 39 weeks due to complications i had and thought it was horrible also. But then again I went into the hospital at 8pn, the gave me the cervidal(which i had an allergic reaction to)so they stopped it. Gave me the pitocin at 7 am the next morning and my DD was born by noon. So given the option to labor for days like some people do or for a few hours.
It all depends on your personal views, and either way your doctor should support that.

Re: Please Discuss - What are your thought re: Elective Induction

With you being a first time mom, (IMO) I would wait it out and have nature do it's thing. Next time around I might entertain the idea being that you have a child at home. In that case it would be convenient for not only the Dr., but for you as well.

If it was my first time, I would want it to just happen. I was medically induced with my third. It wasn't nearly as bad as I thought it was going to be but what saddens me is that I don't have a "story" to tell like I do for my other two. It wasn't exciting. I love when labor happens spontaneously and you either have to call DH at work or wake him up. It's so exciting and such an adrenaline rush!!!!

Think about it, you have time.

Message edited 3/6/2009 11:11:01 AM.

Re: Please Discuss - What are your thought re: Elective Induction

If there were no medical reasons for it, I would never choose to be induced before 40 weeks. I'm not a medical professional, but if a baby is ready, it will come on its own.

I was induced at 38 weeks b/c of high BP and severe swelling. I was 1-2 cm dilated and 70% effaced. I don't know what a non-induced labor feels like, but my induction sucked. I had an epidural and every time I started to get some relief, they had to increase the dosage of pitocin. I didn't rest at all during the induction.

I got to the hospital between 11 a.m. and noon on a Thursday. It took 4 people and 5 different tries to find a good vein and start an IV. I didn't get an IV in until 3 p.m. They started pitocin sometime between 3 p.m. and 5 p.m. The doctor broke my water at 9 p.m. in order to move things along. I got an epidural at 1 a.m. My labor never progressed past 4-5 cm and I ended up with a c-section at 2 p.m. on Friday.

Re: Please Discuss - What are your thought re: Elective Induction

Personally, I don't like to screw with nature unless there is a good reason for it.

Re: Please Discuss - What are your thought re: Elective Induction

Going by my friends' inductions, I wouldn't opt for it unless it was medically necessary or I was past my due date by a few weeks.

I feel that inductions make for a harder labor & everyone's body prepares a baby in its own time.

Re: Please Discuss - What are your thought re: Elective Induction

I was medically induced for DD #1 at 37 weeks and had a good experience with it. It was 11 hours from start to finish.

I have the option of induction for this pregnancy and we are probably going to do it. We are talking close to 39 weeks. For me, it's more planning for the care of DD #1 and having my mom come in from out of state to help. I am a planner so being in control just puts me more at ease.

My Ob predicts a successful induction as I responded well the last time and I will be closer to my due date this time around. He won't induce me unless I am dilated and effaced but again...he says I will be since I was already dilated & effaced at 37 weeks during my last pregnancy.

I wouldn't choose it for a first pregnancy.

Re: Please Discuss - What are your thought re: Elective Induction

Well I'll tell you the *other side*. I was induced with both my daughters- purely for convenience. My doctor had the same stipulations yours does.

I live OOS and we needed someone to take care of the dog with #1, then with #2 we needed someone to come to take care of both the dog and DD#1. The idea of going into labor and not having anyone to come take care of Madelyn TERRIFIED me.

BOTH my inductions went super smooth. I was showing progress (3 cm dilated and 75% effaced for both) already and only needed a little pitocin.

The only complications I for each labor was due to the fact that each of my daughters have wide shoulders. Madelyn needed a vacuum extraction and Eliza came so fast (4 pushes!) she fractured her collarbone. Neither of these were due at all to the inductions.

I will admit- at first I was sad to not have the experience of actually *going* into labor. BUT- the stress that going into labor during a bad time overrode that sadness. Once I was in the hospital ready to go, that sadness was replaced by excitement.

Good luck with your decision!

Re: Please Discuss - What are your thought re: Elective Induction

I won't do it unless absolutely necessary- and that means if i'm way past my due date or having major complications at the end that will put my baby in danger.

I want this baby to come out when (s)he's good and ready.

Re: Please Discuss - What are your thought re: Elective Induction

Honestly, I think that is extremely unethical and I would be horrified if I found out my doctor did that.

Just because you are 39 weeks does not mean your baby is ready to be born, some are, some aren't. I can't believe a doctor would choose to risk both mother and baby's health for the sake of keeping his business running smoothly. I have to wonder what this nurse considers a "low" c-section rate...

Re: Please Discuss - What are your thought re: Elective Induction

Re: Please Discuss - What are your thought re: Elective Induction

Re: Please Discuss - What are your thought re: Elective Induction

my dr has talked about inducing me at the first appointment ( 6 wks) because of the size of my first son ( he was 9lbs10oz) And he said he wants to avoid an 11 lb baby. Im not 100% on board yet, i had a easy delivery with my son despite his size and i dont want to go against natue if I dont have to. ive seen many inductions end in c section.

Message edited 3/6/2009 12:52:12 PM.

Re: Please Discuss - What are your thought re: Elective Induction

Corect me if I'm wrong, this is the situation more or less: one of two things can happen:

1. you may not even qualify for his inductions (cervix is not ripe etc) then you'll have no choice but to wait it out b/c he won't induce you anyway, or at least not until after your EDD.

2. Your cervix is ripe at 39 weeks and your let's say 1-2 cm dialted. You could either chose induction OR let nature takes it course like it's been.

IMHO, if you are progressing on your own, I'd just let it happen. I know the anticipation can drive you insane but that's what I personaly love about it. I'd hang in there.

Re: Please Discuss - What are your thought re: Elective Induction

We have the same doctor and I ended up being induced with an "unfavorable" cervix due to high BP.

Anyway, prior to my induction he discussed elective induction with me b/c he was supposed to be on vacation the week of my due date. Originally, I was against it b/c I wanted nature to take it's course. As my date got closer I started to consider it b/c I trust him and his section rate is very low b/c he only induces if you're 100% effaced and he just starts pitocin (as opposed to giving you a med to ripen the cervix).

If I hadn't been induced early I would've opted for the elective induction if given the option. I wanted him to deliver my baby and am extremely relieved that e/t went as well as it did. FM if you want to chat further.

Re: Please Discuss - What are your thought re: Elective Induction

If it's not broken, don't fix it. I am a firm believer that mother nature generally knows what she's doing & if the baby hasn't come yet, there may be a reason. IMHO, if your cervix is ripe & you are dilating, that means your body is doing exatly what it's supposed to be doing. If your body is already preparing for labor, I see no reason why it needs to be rushed along purely for convenience (esp when it's for the doctor's convenience). Induction & augmentation generally make labor more difficult & it comes with a definite increase in the risk of needing a c-section.

I understand it's a personal decision, so I don't mean to offend anyone who chooses that route, but it's just not for me. I'd much rather the experience of going into labor on my own & letting choose his own birthdate.

Re: Please Discuss - What are your thought re: Elective Induction

I do not think I would do it, especially not because it is more convenient for the doctor....I actually think that is kind of ballsy for him to say

that said, I was induced for medical reasons and wound up with a c-section

this time around, I am going right for the scheduled c-section

Re: Please Discuss - What are your thought re: Elective Induction

Personally I would love to be induced.

However, my practice prefers not to do it unless it is medically necessary.

Re: Please Discuss - What are your thought re: Elective Induction

if your cervix is ripe and you are already dialated then it is augment not induce.

I was at 4 cm dialated and got augmented with pitocin.

My views on induction and augmentation are such that it depends on the type of delivery you want.

Pitocin makes contractions come on faster and harder. It makes a natural labor impossible and you should get the epidural 1st, before any water being broken and before the pitocin.

USUALLY contractions come on gradually and you get to adjust, with pitocin its like BAM and you are already in super active hardcore labor, close to impossible to adjust to that.

In terms of safety....... at 39 weeks that baby is ready... the possibility of your baby ending up in NICU is slim to non existant if everything is done properly.

Some babies dont want to come out at 42 weeks, at 44 weeks, etc........... so what, doesnt mean they arent ready, they are babies, they dont know what is best, and our bodies do not always operate as planned. There are women that just do not go into labor. or labor starts and stops and you are just stuck there. THis is a rare case, but so is NICU at 39 week with a normal healthy baby.

Overall i would say that you should do more reaserch and not trust your doctor just because he is the one with the medical degree and experience. You should be more aware of what type of labor you want and how Pitocin and induction can contribute positevely or negatively to what you want.

Doctors do not always know what is best for YOU. You should use them as a guide and to do what you want, not as a master of your body.

Re: Please Discuss - What are your thought re: Elective Induction

Hindsight being what it is, I would never get a "selective" induction.

When I was PG with my first baby, I went in ON my due date for an appt and was 4 cm dilated. Was sent to the hospital for an induction because I had low fluid.

14 hours of labor later, I "stalled" at 9 centimeters and was sectioned.

Personally, I say do not mess with mother nature.

Re: Please Discuss - What are your thought re: Elective Induction

I don't know part of me feels that nature should take its course. Had you asked me three weeks ago that would be my answer, but in my case my DD did not want to come out on her own (she was not triggering labor) and at 41 weeks my water broke, but I had no contractions. At that point I could not be induced anymore because the baby's heart was not picking up with contractions (due to being post due date) and I ended up needing a c-section.

So in my case I wish I was induced earlier. I would not have needed a c section.

I also think that many OB practices do inductions for convenience. I don't know if I think it's unethical as long as there are strict guidelines. I don't think it's good to go past your due date either. My ob's office won't let you go more than a week late.

Message edited 3/6/2009 2:40:01 PM.

Re: Please Discuss - What are your thought re: Elective Induction

Thanks for all of your opinions and/or experiences.

I also asked my cousin (who is an OBGYN @ Stonybrook) and she agrees that although being called in at 2am sucks, she'd rather her patients go into spontaneous labor because inducing increases the risk for a section, and although it's a completely safe and regular procedure, it's still surgery - And as with any surgery, there are risks involved.

I think I am most comfortable with going into labor on my own, and HOPEFULLY I won't even have to have this conersation w/ him b/c I won't be a candidate for it -
I just never even thought about it until she mentioned it last night and wanted to hear what others thought -

I have done a lot of research and have taken the classes and honestly, I am willing to do whatever is best for the baby - I would rather NOT have major abdominal surgery, but if that's what it comes down to, I'm not going to fight about it - But like you said, the induction increases the risk, even if it's low ........and there's ALWAYS a risk of needing 'help' to move things along, or to have a section or whatever, but I'd rather need those things b/c of something that happend which was out of my control, not something I 'forced'

My DH works in health care and knows the ins and outs of everything, so believe me, he wouldn't allow me to blindly follow the Dr. even if I WAS the type to do that ........(which while I don't like to be a PITA, I will speak up if I'm about something - like this)

Thanks again !!

Re: Please Discuss - What are your thought re: Elective Induction

Inductions are very risky. There are far more cons than pros IMO.

It increases your chance for a c-section by 30%. Because pitocin causes contractions to be longer and harder than natural ones, it also increases the chances of fetal distress.

If your doctor uses the Bishop score to determine whether to induce a patient, then it makes some sense that his c-section rate is lower than average. But I still wouldn't induce on a whim.

Re: Please Discuss - What are your thought re: Elective Induction

i'm sure your doctor is using a lot more than his intuition when deciding who to induce. there is actually a widely-used, evidence-based scale that takes a bunch of factors into account (dilation, effacement, station, etc) called the "bishop score"; it's pretty good for predicting which inductions will be successful. that score, plus many years of experience, are probably what account for your doc's low c-section rate.

here's a blurb on it from wikipedia:
[L=http://en.wikipedia.org/wiki/Bishop_score]

having said that, my bishop score was through the roof at 39 weeks and i still declined an induction. i saw absolutely no need to put myself at even the slightest bit higher risk of major abdominal surgery.

plus, i figured that as "ripe" as my cervix was, if my body was really ready i would have gone into labor on my own (which i did, 4 days later).

sure, there are instances where your body doesn't do what it's supposed to do and you need to be induced... but i figured, why not give my body a chance?

jmo... to each his own. good luck making your decision